Palliative wound treatment promotes healing

Abstract

Introduction: Wounds are a major problem at the end of life, affecting nearly one-third of hospice patients. The main patient complaints associated with these wounds are pain, infection, and odor, often making wound care difficult due to patient discomfort and the complicated nature of the wounds. Materials and Methods. A method of wound treatment invented in 2001 for palliative wound care was designed to meet the goals of pain relief, odor control, and infection prevention. This method, which involved application of viscous lidocaine and topical polymyxin/bacitracin to gauze, was used on hundreds of hospice patients and, later, on non-hospice patients as well. A retrospective review of results was undertaken. Results: This paper presents 2 descriptive retrospective observational reviews. One is a retrospective review of 323 wounds in hospice patients treated over a period of 30 months using the palliative wound treatment method. In this cohort, more than 40% of pressure ulcers healed to closure or were healing by the end of the study; 30% of ischemic ulcers were healed to closure or were healing by the end of the study,; and more than 40% of neuropathic ulcers were healing by the end of the study. In total, nearly 40% of all wounds were in the process of healing or healed to closure. The second study is a retrospective review of nursing home data using the palliative wound treatment method. In a cohort of 72 patients with 156 mixed wound types followed for 1 year, rates of healing to closure approached 95% after 12 weeks of treatment. Conclusion: While meeting palliative goals of reducing pain, preventing infection, and controlling odor, use of this method also provided unexpected healing. Further investigation on use of this method is warranted.